We appreciate the comments raised and our response is as follows; the "Obesity paradox" has not only been defined with respect to patients with myocardial infarction, but also in patients with heart failure (HF) resulting from multiple etiologies. [1],[2] In fact, in the Kenchaiah et al., study group, while ischemic heart disease was the predominant cause of HF in lower body mass index (BMI) categories, hypertension was the primary factor attributable to HF in higher BMI categories. [3]

In the study by Tanalp et al., [4] they examined 96 obese subjects, and 50 normoweight subjects, without any history of a systemic disease and/or medication use. This contrasts the HF population on medications in our study [5] and so it might be difficult to directly compare the results of both studies. However, from the study by Tanalp et al., we acknowledge that there is a need to attempt to verify the results in our own study population by novel advanced echocardiographic methods.